Mollahüseyinoğlu Küllaç Fatmanur, Özdemir Ayşe Zehra, Yildiz Çağlanur
Bafra State Hospital, Obstetrics-Gynecology Department, Samsun, Turkey.
Ondokuz Mayis University Faculty of Medicine, Obstetrics-Gynecology Department, Samsun, Turkey.
Medicine (Baltimore). 2024 Dec 13;103(50):e40881. doi: 10.1097/MD.0000000000040881.
In our study, we aimed to retrospectively compare vNOTES hysterectomy, a new method, with a vaginal hysterectomy (VH) and total laparoscopic hysterectomy (TLH). Our study included 186 hysterectomy cases (62 vNOTES hysterectomy, 62 VH, and 62 TLH) with benign indications diagnosed between 2021 and 2022. Our study is a retrospective and single-center study. Three surgical techniques were evaluated comparatively according to demographic characteristics and surgical results. The least hemoglobin (Hb) decline and the longest mean operation time were observed in the vNOTES hysterectomy group. When discharge times were compared, it was observed that the vNOTES hysterectomy group was discharged significantly shorter than the TLH group (P: .022 < .05). The lowest 6th-hour pain score of 1.53 was observed in the vNOTES hysterectomy group. History of pelvic surgery and cesarean section were higher in the vNOTES hysterectomy group than in the VH group. Also, oophorectomy and salpingectomy rates were higher in the vNOTES hysterectomy group than in the VH group. When intraoperative complications were evaluated, bladder perforation was encountered in one vNOTES hysterectomy and two VH operations, and bleeding was observed in one VH operation. The VH group was the least costly operation compared to vNOTES hysterectomy and TLH (P: .003 < .05, P: .01 < .05). Aesthetic results can be achieved for patients by using the vaginal route. With all these results, we believe that vNOTES hysterectomy is a safe alternative to TLH and VH.
在我们的研究中，我们旨在回顾性地比较一种新方法——经自然腔道内镜手术子宫切除术（vNOTES子宫切除术）与阴道子宫切除术（VH）和全腹腔镜子宫切除术（TLH）。我们的研究纳入了2021年至2022年期间诊断为良性指征的186例子宫切除术病例（62例vNOTES子宫切除术、62例VH和62例TLH）。我们的研究是一项回顾性单中心研究。根据人口统计学特征和手术结果对三种手术技术进行了比较评估。vNOTES子宫切除术组观察到血红蛋白（Hb）下降最少且平均手术时间最长。比较出院时间时，发现vNOTES子宫切除术组的出院时间明显短于TLH组（P：0.022＜0.05）。vNOTES子宫切除术组观察到第6小时最低疼痛评分为1.53。vNOTES子宫切除术组盆腔手术和剖宫产史高于VH组。此外，vNOTES子宫切除术组卵巢切除术和输卵管切除术的发生率高于VH组。评估术中并发症时，1例vNOTES子宫切除术和2例VH手术中出现膀胱穿孔，1例VH手术中观察到出血。与vNOTES子宫切除术和TLH相比，VH组手术成本最低（P：0.003＜0.05，P：0.01＜0.05）。通过阴道途径可为患者实现美学效果。基于所有这些结果，我们认为vNOTES子宫切除术是TLH和VH的一种安全替代方法。
